Graduate Program in Food, Nutrition, and Health, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Graduate Program Sciences in Gastroenterology and Hepatology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Nutr Clin Pract. 2024 Aug;39(4):911-919. doi: 10.1002/ncp.11147. Epub 2024 Apr 4.
The emergency department (ED) is the most frequent access route to the hospital. Nutrition risk (NR) screening allows the early identification of patients at risk of malnutrition. This study aimed to evaluate the feasibility and predictive validity of five different tools in EDs: Nutritional Risk Screening 2002 (NRS-2002), Nutritional Risk Emergency 2017 (NRE-2017), Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT), Malnutrition Universal Screening (MUST), and Malnutrition Screening Tool (MST).
Patients with scores ≥3 according to the NRS-2002, ≥1.5 according to the NRE-2017, and ≥2 according to the MUST, RFH-NPT, or MST were classified with NR. Prolonged length of stay (LOS) and 1-year mortality were evaluated.
431 patients were evaluated (57.31 ± 15.6 years of age; 54.4% women) in a public hospital in southern Brazil. The prevalence of NR was: 35% according to the NRS-2002, 43% according to the MST, 45% according to the NRE-2017 and MUST, and 49% according to the RFH-NPT. Patients with NR, had a greater risk of prolonged LOS (P < 0.001). The presence of NR was associated with an increased risk of 1-year mortality according to the NRS-2002 (hazard ratio [HR]: 4.04; 95% CI, 2.513-6.503), MST (HR: 2.60; 95% CI, 1.701-3.996), NRE-2017 (HR: 4.82; 95% CI, 2.753-8.443), MUST (HR: 4.00; 95% CI, 2.385-6.710), and RFH-NPT (HR: 5.43; 95% CI, 2.984-9.907).
NRE-2017 does not require objective data and presented predictive validity for all outcomes assessed, regardless of the severity of the disease, and thus appears to be the most appropriate tool for carrying out NR screening in the ED.
急诊科是进入医院最常见的途径。营养风险（NR）筛查可早期识别有营养不良风险的患者。本研究旨在评估五种不同工具在急诊科的可行性和预测效度：营养风险筛查 2002（NRS-2002）、营养急诊 2017（NRE-2017）、皇家自由医院-营养优先工具（RFH-NPT）、营养不良通用筛查（MUST）和营养不良筛查工具（MST）。
NRS-2002 评分≥3、NRE-2017 评分≥1.5、MUST、RFH-NPT 或 MST 评分≥2 的患者被归类为存在 NR。评估了延长住院时间（LOS）和 1 年死亡率。
在巴西南部的一家公立医院评估了 431 名患者（57.31±15.6 岁；54.4%为女性）。NR 的患病率为：NRS-2002 为 35%，MST 为 43%，NRE-2017 和 MUST 为 45%，RFH-NPT 为 49%。NR 患者 LOS 延长的风险更大（P<0.001）。NR 的存在与 NRS-2002（危险比 [HR]：4.04；95%CI，2.513-6.503）、MST（HR：2.60；95%CI，1.701-3.996）、NRE-2017（HR：4.82；95%CI，2.753-8.443）、MUST（HR：4.00；95%CI，2.385-6.710）和 RFH-NPT（HR：5.43；95%CI，2.984-9.907）的 1 年死亡率增加相关。
NRE-2017 不需要客观数据，并且对所有评估的结果均具有预测效度，而与疾病的严重程度无关，因此似乎是急诊科进行 NR 筛查的最合适工具。
